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I've had INR readings at 4.2 and higher. At one time, I even had one around 7 (according to a doctor I used to see). It could be that the blood was mishandled, it could be that my then irregular testing actually enabled me to let my INR get out of control).
I use two or three different meters for testing, and one meter may say 3.2 while another says 4.2 (or higher). I don't really let it trouble me to be in the low to mid 4s. At 4 and higher many clinics will get a blood draw to confirm the value.
The easiest way to deal with a 4.2 is probably to add some greens to your diet. Also - try to stay away from sharp objects and to avoid impacts that can cause bruising. In my experience, a 4.2 isn't that big a deal as long as I'm a bit more cautious than usual. When it gets to 5, 6, or above THEN you should confirm with another meter or a blood draw, check with a doctor, and probably consider taking some Vitamin K supplements to bring it down fairly rapidly. A 4.2, though, doesn't really concern me too much.
I can beat that - I got up to 9.0 last year after a week of taking my warfarin with grapefruit juice! But I had absolutely no symptoms and may have been that high (or higher) for an entire week. I only found out because I had a blood draw for something unrelated and they threw in the INR just because they already had some blood.
Pellicle's absolutely right. Seeing how they handle a 4.2 may give you a good idea of how they will actually manage your dosing. If the approach is conservative, rather than a knee-jerk (skip a dose instruction or something similar), you're probably okay. It'll be interesting to see how they handle it.